COVID-19 is a new virus and there is a never-ending stream of updates. The uncertainty about the virus and the changes that are rapidly unfolding no doubt make most of us feel on edge. This is normal, and mild anxiety can actually motivate us to take to take action to protect ourselves and others, and to learn more about the pandemic. That being said, we all like stability, routine, and a sense of control over our environments and experience tremendous stress when there are disruptions in our normal lives!
COVID adds a new challenge for pregnant women, women delivering their babies and the postpartum period. All of these can be stressful times and 10-20% of women may develop a perinatal mood or anxiety disorder (PMAD) in the best of times, but COVID adds a very difficult layer. For example, adjusting to parenthood after delivery is challenging under normal circumstances, let alone in the midst of a global pandemic. Concerns about exposure to COVID-19, combined with physical distancing recommendations, can worsen depression and decrease access to the resources, such as health care and social supports, that women typically use to build resilience and promote recovery. Despite these challenges, there are several steps women with a perinatal mood or anxiety disorder can take to optimize their mental health and thrive in the face of COVID-19.
1. Prioritizing Self-Care: Remember the acronym R.E.S.T. (image below) and keep in mind that during these unique times self-care might include limiting/minimizing your media/news consumption and being creative about how you exercise:
2. Access Social Support: Related to Therapy, above, social support can be invaluable at this time - especially for women who have mild (not severe) symptoms of anxiety, depression or stress. However, COVID-19 presents unique barriers to engaging supports, particularly those outside of the home. Partners are a logical first choice, but if one is not present (or able), it may be helpful to seek outside help from family or friends. One silver lining in the COVID-19 cloud is that many restrictions on telehealth – particularly teletherapy and telepsychiatry – have been lifted. Many providers and support groups have quickly pivoted to offer meetings and therapy online. Here are some notable resources for women who are pregnant or new moms struggling with anxiety or depression:
Postpartum Support International offers daily on-line support groups, links to local resources in all 50 states, and an online provider directory.
The Bloom Foundation hosts virtual support groups.
Maternal Mental Health Now has designed a new resource to help you feel prepared to adjust to the emotional demands, joys, and stressors of trying to conceive, pregnancy and parenting. They also partnered with Dignity Health to provide a series of virtual support groups:
3. Experience all of your emotions: Dr. Kessler who is the world’s foremost expert on grief was recently interviewed and suggested that we are currently experiencing several types of griefs (collective, anticipatory). All of the feelings that come along with this COVID-related grief are overwhelming and trying to stop them to avoid feeling sad or angry in our grief will not help.
Kessler says: When you name it, you feel it and it moves through you. Emotions need motion. It’s important we acknowledge what we go through. One unfortunate byproduct of the self-help movement is we’re the first generation to have feelings about our feelings. We tell ourselves things like, I feel sad, but I shouldn’t feel that; other people have it worse. We can — we should — stop at the first feeling. I feel sad. Let me go for five minutes to feel sad."
Give yourself permission to feel. Disappointment around creating a new birth plan? #Anxious about rescheduling your baby shower? Let those feelings move through you and move on. "Let yourself feel the grief and keep moving."
4. Radical Acceptance: Taking the approach of radical acceptance can be important when dealing with an overwhelming situation such as the current one. It is about recognizing and accepting the truth of the situation, even if it is difficult. It is also not burying our heads in the sand. For example, it is not continuing with our daily routine like nothing has changed. Many of our typical routines have changed substantially. It is recognizing what is and where we can act and respond accordingly. It is realizing what is out of our control, but also what is within our control.
Some example of this for pregnant and postpartum women would be:
1. March of Dimes has created a wonderful resource for women to update their birth plan and realizing that what we plan may still not come to happen in COVID times. for this purpose: COVID UPDATED BIRTH PLAN.
2. Evidence Based Birth has high-quality online childbirth education classes.
3. LiveHealthOnline has online lactation and breastfeeding support.
4. National Domestic Violence Hotline helps women create a safety plan HERE.
Dr. Accortt in the News
May 2020: Hawaii News Now, Sunrise, How to Prevent Anxiety & Depression Before and After Giving Birth
April 2020: The Bump, How to Spot Postpartum Depression in Your Partner or Friend
12/3/19: Quartz, Ten questions about mothers’ mental health could promote resilient pregnancies
5/10/19: CGTN America, US comedian uses her act to turn the spotlight on postpartum depression
5/1/19: KTLA News, How One Comedian’s Battle With Postpartum Depression Turned Laughs Into Legislation
3/20/19: KFI News Radio, FDA Approves First Drug for PPD, Brexanolone (Zulresso) - Correction: Rix states that Dr. Accortt "treats thousands of women at CS" - Thousands of women delivery babies at CS every year. Dr. Accortt does not treat them.
Winter 2019: Cedars-Sinai Discoveries Magazine, Stop The Stigma
9/11/18: USC Center for Health Journalism, Cedars-Sinai PPD Screening Program May be Model for State
Summer 2018: Cedars-Sinai Catalyst Magazine, The Helping Hand of Los Angeles Funds Postpartum Depression Screening Program, scroll down to page 40 of magazine
5/18/18: TODAY.com, Alyssa Milano on Postpartum Anxiety
5/3/18: Cedars-Sinai Maternal Mental Health Research
10/19/17: Cedars-Sinai Postpartum Depression Screening Program
3/24/17: MomCo. App for Social Support
Dr. Accortt is a California licensed clinical psychologist. When she isn't seeing patients in private practice she conducts research in the OBGYN department at Cedars-Sinai. She will update this page with important maternal mental health news and research.